Moderna’s Skin Cancer Vaccine Is Looking Seriously Promising

Before COVID, few people had heard of Moderna. They were a quiet underdog with a mission that sounded like science fiction: using mRNA to train the body to delete its own cancer. Today, that mission looks like a looming reality.

Five years ago, a group of high-risk skin cancer patients received a bespoke vaccine. The data is finally in, and the results are striking. The vaccine, paired with an immunotherapy drug, slashed the risk of recurrence or death by 49% compared to immunotherapy alone. This is evidence of a strong, lasting immune memory.

Fighting Cancer

Cancer is essentially a corrupted version of “you.” This is why your immune system often lets it slide under the radar. Historically, our tools to fix this have been blunt instruments. Standard chemotherapy is a sledgehammer — it hits everything, hoping to kill the cancer before it kills the patient. Radiotherapy is like “carpet bombing” the body.

The new treatment greatly finesses that approach.

Developed by Moderna and Merck, the treatment is fully customized. Doctors sequence a patient’s specific tumor and their healthy blood to find “typos” in the DNA — mutations present only in the cancer. In this trial, researchers identified up to 34 of these unique markers, known as neoantigens. They use these markers to print a “most wanted” poster for the immune system, teaching it exactly what to hunt.

So, unlike “conventional” treatments, which are the same for everyone, this one is tailored to your specific situation. The researchers use those unique markers to teach the body to detect exactly the type of tumor it has. It’s like a “most wanted” poster for cancer.

After the body recognizes the tumor, the immunotherapy drug (Keytruda) helps the immune system defeat it.

The Data Is In

In oncology, the five-year mark is the gold standard for durability. If a treatment still works after half a decade, it’s changing the survival curve. Because the 49% reduction held steady from previous years, we know the immune system’s “memory” remains sharp. It’s not perfect, but for the 112,000 Americans expected to face a melanoma diagnosis this year, it’s a new ray of hope.

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But the implications here go far beyond skin cancer. If you can train the body to recognize 34 mutations in a melanoma cell, why not 34 mutations in a lung tumor? Or a bladder tumor? Or a kidney? This is the “platform” strategy that Moderna has been betting on since the height of the COVID-19 pandemic. They proved mRNA could handle a virus and support a vaccine. Now, they are proving it can handle the body’s own mutiny.

Trials are already underway for non-small cell lung cancer and renal cell carcinoma. The beauty of this technology is its speed and adaptability. Once the sequencing is done, the mRNA “software” can be written and manufactured in weeks.

The Challenges

While we’re moving to an era of precision treatments, there are still very serious obstacles.

For starters, this is a small-scale study. A total of 157 patients participated in the mid-stage study, with 107 receiving the personalized vaccine combination and 50 receiving standard immunotherapy alone. That means Moderna will need to replicate the results on a bigger cohort. Plus, it remains to be seen how the treatment will fare in the even longer run.

Then, the even bigger challenge is cost.

Analysts estimate this personalized cocktail could carry a price tag of around $200,000 per patient. For many people, that’s simply unaffordable.

But perhaps the math works out. If half of those people avoid years of subsequent surgeries, hospitalizations, treatments, and loss of life quality, the vaccine could actually be saving money. The high upfront cost of a highly effective treatment should be measured against a lifetime of chronic illness. Plus, the more the treatment is scaled up, the cheaper production will become.

This isn’t to say that the treatment is cheap. Just that the alternative sounds even worse.

We aren’t looking at the “end of cancer” just yet. But we are moving away from carpet-bombing the body. By 2030, the “Standard of Care” might not be a generic drug from a shelf, but a custom-coded cure designed specifically for you.